Efficacy of tablet-based applications for mental training in preserving cognitive abilities of older adults

Authors

  • Marcello Maria Turconi Fablab Srl, Trieste - Italy
  • Filomena Vella Azienda Sanitaria Universitaria Integrata di Trieste 1, Trieste - Italy
  • Francesco Mosetti Azienda Pubblica di Servizi alla Persona ITIS, Trieste - Italy

DOI:

https://doi.org/10.33393/abtpn.2019.282

Keywords:

aging, cognitive decline, cognitive training, mental training, older adults

Abstract

Background and aims: Nonpathological, age-related cognitive decline is among the most feared consequences of aging. Evidence suggests that the continued use of mental abilities can slow down cognitive decline. We developed two tablet-based applications for the mental training (ElasticaMente) and social interaction/entertainment (iNonni) of older adults. The aim of this study was to evaluate their effect on cognitive performance.
Materials and methods: This was an exploratory study of 8 months duration. Sixty healthy residents of a senior community center aged ≥60 years were recruited and divided into three groups: participants in Groups 1 and 2 received a tablet with ElasticaMente and iNonni (Group 1, n = 20) or with iNonni only (Group 2, n = 20); participants in Group 3 (n = 20) did not receive any tablet. Participants in Groups 1 and 2 were instructed to use the applications three times a week (each session ~45 minutes). Cognitive performance was assessed at baseline (T0) and after 8 months (T1) using a battery of six validated tests.
Results: In Group 1, cognitive test scores remained consistently stable from T0 to T1, suggesting maintenance of cognitive abilities. In contrast, in Groups 2 and 3, scores worsened from T0 to T1 across all tests. Comparison of the changes from T0 to T1 revealed statistical significance for Group 1 versus Group 3, but not for Group 1 versus Group 2 and Group 2 versus Group 3.
Conclusion: The 8 months use of the applications ElasticaMente and iNonni was associated with a significant benefit in terms of preserved cognitive performance compared with no tablet-based activity. The potential contribution of ElasticaMente to the attenuation of cognitive decline should be further investigated. (Digital Health)

References

  1. Deary IJ, Corley J, Gow AJ, et al. Age-associated cognitive decline. Br Med Bull. 2009;92:135-152.
  2. Chan MY, Haber S, Drew LM, Park DC. Training older adults to use tablet computers: does it enhance cognitive function? Gerontologist. 2016;56(3):475-484.
  3. Lee SH, Kim YB. Which type of social activities may reduce cognitive decline in the elderly? A longitudinal population-based study. BMC Geriatr. 2016;16(1):165.
  4. Marioni RE, Proust-Lima C, Amieva H, et al. Social activity, cognitive decline and dementia risk: a 20-year prospective cohort study. BMC Public Health. 2015;15:1089.
  5. Mitchell MB, Cimino CR, Benitez A, et al. Cognitively stimulating activities: effects on cognition across four studies with up to 21 years of longitudinal data. J Aging Res. 2012;2012:461592.
  6. Amieva H, Mokri H, Le Goff M, et al. Compensatory mechanisms in higher-educated subjects with Alzheimer’s disease: a study of 20 years of cognitive decline. Brain. 2014;137(Pt 4):1167-1175.
  7. Cheng ST. Cognitive reserve and the prevention of dementia: the role of physical and cognitive activities. Curr Psychiatry Rep. 2016;18(9):85.
  8. Nucci M, Mapelli D, Mondini S. Cognitive Reserve Index questionnaire (CRIq): a new instrument for measuring cognitive reserve. Aging Clin Exp Res. 2012;24(3):218-226.
  9. Willis SL, Schaie KW. Cognitive training and plasticity: theoretical perspective and methodological consequences. Restor Neurol Neurosci. 2009;27(5):375-389.
  10. León I, Garcia-García J, Roldán-Tapia L. Estimating cognitive reserve in healthy adults using the Cognitive Reserve Scale. PLoS One. 2014;9(7):e102632.
  11. Ball K, Berch DB, Helmers KF, et al; for the ACTIVE Study Group. Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA. 2002;288(18):2271-2281.
  12. Hardy JL, Nelson RA, Thomason ME, et al. Enhancing cognitive abilities with comprehensive training: a large, online, randomized, active-controlled trial. PLoS One. 2015;10(9):e0134467.
  13. Owen AM, Hampshire A, Grahn JA, et al. Putting brain training to the test. Nature. 2010;465(7299):775-778.
  14. Miller KJ, Siddarth P, Gaines JM, et al. The memory fitness program: cognitive effects of a healthy aging intervention. Am J Geriatr Psychiatry. 2012;20(6):514-523.
  15. Rebok GW, Ball K, Guey LT, et al; for the ACTIVE Study Group. Ten-year effects of the advanced cognitive training for independent and vital elderly cognitive training trial on cognition and everyday functioning in older adults. J Am Geriatr Soc. 2014;62(1):16-24.
  16. Smith GE, Housen P, Yaffe K, et al. A cognitive training program based on principles of brain plasticity: results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) study. J Am Geriatr Soc. 2009;57(4):594-603.
  17. Wolinsky FD, Vander Weg MW, Howren MB, Jones MP, Dotson MM. A randomized controlled trial of cognitive training using a visual speed of processing intervention in middle aged and older adults. PLoS One. 2013;8(5):e61624.
  18. Willis SL, Tennstedt SL, Marsiske M, et al; for the ACTIVE Study Group. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA. 2006;296(23):2805-2814.
  19. Chiu HL, Chu H, Tsai JC, et al. The effect of cognitive-based training for the healthy older people: a meta-analysis of randomized controlled trials. PLoS One. 2017;12(5):e0176742.
  20. Kane RL, Butler M, Fink HA, et al. Interventions to prevent age-related cognitive decline, mild cognitive impairment, and clinical Alzheimer’s-type dementia. Comparative Effectiveness Review No. 188. Report No. 17-EHC008-EF. Rockville, MD: Agency for Healthcare Research and Quality, 2017.
  21. Kelly ME, Loughrey D, Lawlor BA, Robertson IH, Walsh C, Brennan S. The impact of cognitive training and mental stimulation on cognitive and everyday functioning of healthy older adults: a systematic review and meta-analysis. Ageing Res Rev. 2014;15:28-43.
  22. Lampit A, Hallock H, Valenzuela M. Computerized cognitive training in cognitively healthy older adults: a systematic review and meta-analysis of effect modifiers. PLoS Med. 2014;11(11):e1001756.
  23. Anguera JA, Boccanfuso J, Rintoul JL, et al. Video game training enhances cognitive control in older adults. Nature. 2013;501(7465):97-101.
  24. Anguera JA, Gazzaley A. Video games, cognitive exercises, and the enhancement of cognitive abilities. Curr Opin Behav Sci. 2015;4:160-165.
  25. Lu MH, Lin W, Yueh HP. Development and evaluation of a cognitive training game for older people: a design-based approach. Front Psychol. 2017;8:1837.
  26. Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-198.
  27. Measso G, Cavarzeran F, Zappala G, et al. The Mini-Mental State Examination: normative study of an Italian random sample. Dev Neuropsychol. 1993;9:77-85.
  28. Nasreddine ZS, Phillips NA, Bedirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-699.
  29. Santangelo G, Siciliano M, Pedone R, et al. Normative data for the Montreal Cognitive Assessment in an Italian population sample. Neurol Sci. 2015;36(4):585-591.
  30. Mondini S, Mapelli D, Vestri A, Bisiacchi PS. Esame neuropsicologico breve 2: Una batteria di test per lo screening neuropsicologico. [A battery of tests for neuropsychological screening]. Raffaello Cortina Editore, Milano. Libro 2011. [Article in Italian].
  31. Appollonio I, Leone M, Isella V, et al. The Frontal Assessment Battery (FAB): normative values in an Italian population sample. Neurol Sci. 2005;26(2):108-116.
  32. Dubois B, Slachevsky A, Litvan I, Pillon B. The FAB: a Frontal Assessment Battery at bedside. Neurology. 2000;55(11):1621-1626.
  33. Iavarone A, Ronga B, Pellegrino L, et al. The Frontal Assessment Battery (FAB): normative data from an Italian sample and performances of patients with Alzheimer’s disease and frontotemporal dementia. Funct Neurol. 2004;19(3):191-195.
  34. Jones G, Macken B. Questioning short-term memory and its measurement: why digit span measures long-term associative learning. Cognition. 2015;144:1-13.
  35. Measso G, Zappala G, Cavarzeran F, et al. Raven’s colored progressive matrices: a normative study of a random sample of healthy adults. Acta Neurol Scand. 1993;88(1):70-74.
  36. Cattell RB. Theory of fluid and crystallized intelligence: a critical experiment. J Educ Psychol. 1963;54(1):1-22.
  37. Vaportzis E, Martin M, Gow AJ. A tablet for healthy ageing: the effect of a tablet computer training intervention on cognitive abilities in older adults. Am J Geriatr Psychiatry. 2017;25(8):841-851.